Background:
College students represent an important population potentially at risk for sexually transmitted infections (STI). Screening, diagnosis and treatment of STIs is often provided by an on-campus health center, but availability may vary by institution. Incidence rates for STIs are not well described for this population.

Objective:
To determine the STI testing practices at U.S. colleges and universities, and to measure the proportion of positive test results reported for selected conditions.

Method:
A web-based survey was developed by the American College Health Association and offered to U.S. institutions of higher education. Surveys were completed online by a representative of the institution's health service. Questions addressed STI test availability, methods and test result data.

Result:
Data were collected from 135 institutions, representing a total enrollment of 2.0 million students and 2.6 million patient visits. STI testing for one or more infections was available at 95% of institution health centers; chlamydia, herpes and HIV testing were each offered by 87% of centers, and reflex HPV testing by 74%. Chlamydia test positivity was 3.4% for women and 7.4% for men. Fifty percent of positive genital herpes culture or PCR results were due to HSV-1. Less than 25% of institutions reported cases of HIV or syphilis; overall test positivity was 0.17% for HIV, and 0.24% for syphilis.

Conclusion:
Tests for common STIs are widely available in this group of college health services. Positivity rates for selected infections vary considerably by institution and gender, and may reflect different indications for testing. A large proportion of genital herpes infections were caused by HSV-1. HIV and syphilis infections were infrequent.

Implications:
Screening for STIs should continue to be promoted in this population. Survey data may assist with estimates of incidence for these infections among U.S. college students and help to establish benchmarks for testing practices at college health services.